Predictors of glucocorticoid-free remission in patients with polymyalgia rheumatica treated with prednisolone.

Abstract

This study aimed to identify predictive factors of glucocorticoid (GC)-free remission in patients with polymyalgia rheumatica (PMR) treated with prednisolone (PSL). Among 75 PMR patients in our single-center registry, this retrospective study targeted 20 patients who achieved GC-free remission (Remission group) and 30 patients who continued treatment with PSL (PSL group) at 30months from the initiation of PSL treatment (baseline). There was no significant difference between Remission and PSL groups in baseline demographics. C-reactive protein (CRP) decreased more rapidly at 1 and 3months from baseline in the Remission group than in the PSL group (P=.013 and .046, respectively). Multivariate logistic regression analysis revealed that the normalization of CRP at 1month was associated with the achievement of GC-free remission (odds ratio=5.83, 95% CI=1.28-26.51, P = .023). In addition, when CRP at 1month was≤0.17mg/dL, as determined by receiver operating characteristic curve analysis, both the daily PSL dose and cumulative PSL dose were lower, and the rate of GC-free remission higher, at 30months compared to when CRP at 1month was>0.17mg/dL (P=.010, .049 and .004, respectively). The normalization of CRP within 1month from baseline predicted GC-free remission in PMR patients treated with PSL, and resulted in a lower cumulative PSL dose.